The lung infection is most likely secondary to being on a ventilator. When ventilated most of your normal barriers to lung infection are bypassed and its incredibly common you get pneumonia. Its called vap – ventilator acquired pneumonia. Wishing simon all speed in his recovery

Any “decent anaesthetist” would say wait till you are well – regional is an option – but you wouldn’t want a full spinal for a day case procedure – and otherwise unless you have an anaesthetist who specialises in regional anaesthesia they probably wont be happy doing you awake just under blocks. If your in a big ortho place that does lots of regionals maybe different. I haven’t got any experience of this particular op. Some ortho surgeons are also very unkeen on blocks because it can mask problems with compartment syndrome post op – but that shouldnt be a problem with an ankle.

Where I work I know alot of consultant anaesthetists who work various lists who are crap at blocks.

It all depends how bad your cold is – which cant be decided over the internet – and how long they would have to reschedule you for. The other factor is that its ultimately your decision – you could say that I’m happy to take the risk, me I would wait for a couple of weeks if thats an option.

Its more of a risk with children, but having an upper respiratory tract infection increases your chance of having air way hyper reactivity – basically increases the chances slightly you could get laryngospasm – where your vocal chords close post surgery or bronchospasm – where your airways narrow.

Like I said the evidence is mostly for it being a problem in children – but for a purely elective procedure – which it sounds like yours is most anaesthetists would say to wait until your cold has improved.

(I’m a trainee anaesthetist)

Does this help at all?

I see dead bodies all the time through work, you get used to it. One hospital I worked in only had the mortuary staffed certain times of the day – bodies dont bother me in the slightest however it did used to give you the willies slightly going down to a deserted mortuary to get a body out of the fridges when you need to see them after death for certification!

Worst rota I’ve yet worked was 12 days on 2 off. A&E Doc in Swansea.

5 8 hour shifts (9-5,4-12,8-4), followed by 2 12 hour shifts (9-9, 12-12, 2-2) followed by another 5 8 hour shifts. I did that for four months, it gets broken up slightly by night shifts but thats basically it – I struggle to understand how its legal but apparently it is.

Of course I know that, but its in no way guaranteed and was trying to point the op in the path of least resistance. Why would you use that tone “if you work in the NHS?” Do you think I’m lying and that I’m actually a builder?

As someone who works in the NHS I would suggest that waiting for an outpatient CT shouldn’t be that long – certainly probably alot less long than the surgery – so its probably not going to slow the process a great deal. Having the scan done on another site, on another computer system is likely to be a right pain in the arse for your clinicians to look up too (shouldnt be, but IT issues are generally a bit crap). On top of that the surgeon may well want the scan reported by a radiologist they know and trust – not some locum they dont know.

I’d just wait and have it done on the nhs.

Its probably the same engine as my A3 – 2.0 tdi BKD engine. The turbo is a well known weak point on this engine.

The turbo went on mine a couple of weeks ago – I have just replaced it on the driveway. New recon turbo cost £330 from ‘the turbo guy’ up in Glasgow (google them) and you need to replace the oil feed pipe plus manifold gasket. New oil and filter is needed too – about £80 – so all in about £420.

It was a bit fiddly but not an enormously tricky job, depends how mechanically minded you are.

Theres a link to a how to guide below

Linky

Tignes isnt particularly pretty in summer. I went there last year and had a brilliant time. Free lift pass, loads of trails – mostly big DH stuff. Wonderbois is a fantastic trail.

Hospital Doctor, GCSE then a levels, did a degree in Environmental science, worked as a consultant for a year did a masters in Hydrogeology. Worked in research for a year, opportunity came up and managed to get a place on a post graduate medical degree (which was what I initially wanted to do, but my school said I wasn’t clever enough and I believed them). Have been a doctor for last two years, have an interview next week to get onto the anaesthetic training scheme, so hopefully will end up a gas man!

Beta blockers will cause peripheral vasoconstriction, its one of their side effects. You could perhaps use a calcium channel blocker such as verapamil or diltiazem for rate control if its AF your using them for.

A small dose of amlodipine might help – which causes a bit of peripheral vasodilation provided your blood pressure will stand it if you are already on the beta blocker.

Hadn’t read the initial post your 21 and ten stone. It would have to be a very convincing story to make me do troponins. Yours doesn’t sound like that. If i had seen you i wouldnt done troponins either. Stop worrying get on with your life.

Go and speak to your gp. We can’t really help you over a forum. I agree chill out, its likely nothing.

No the blood test needs to have one taken and then another one taken 6 hers afterwards to rule out an mi. The doctors obviously didn’t think the pain sounded cardiac.

Its really hard to say too much from what you have said because we have no details about the pain or nature etc. Sounds unlikely to be cardiac from what you have said though. The ecg being normal doesn’t rule out a cardiac cause of the chest pain – although I would presume the probably did serial troponins (markers of cardiac dysfunction) if the doctors felt that the story sounded cardiac in origin. There is a very small chance of having had an MI with normal ecg and normal troponins.

The pain could well be pleuritic – inflammation of the lining of the lungs – can be very painful.

If the previous ecg’s you have had are normal its unlikely that you have suddenly developed one of the underlying syndromes such as long qt, wolf parkinson white or hypertophic obstructive cardio myopathy which could make you suddenly drop dead – so I wouldnt worry about that.

Overactive thyroid normally causes a fast heart rate but can also cause ectopics – there are other signs such as being hot, brittle hair, excess sweating, loads of energy etc Diagnosed through a blood test, normally relatively easy to treat with drugs, or possibly a small procedure. More common in women that men though.

Paramedics are trained to rule out acute MI on ecg’s mainly and also certain fast heart rythmns – there not taught to look at all the minutiae that Doctors are. Gps should know most of the minutiae but may have forgotten alot of it – hence why sending you to a cardiologist :-)

Bottom line is – dont worry its likely fine – problems in the heart that cause you not to be able to ride a bike again are pretty rare, common things are common i.e. pleuritic chest pain following viral illness but I cant comment specifically as i dont know the history.

Wound should be reasonably well healed within around 10 days – although this varies alot person to person. Also if you go too mad with activity you may delay the wound healing a little. Keeping it dressed will keep the wound moist – which contrary to popular belief actually helps wound healing. I personally would keep it dressed – if you get an infection in a wound with metal work underneath that can be bad news.

AE doctor on dinner break here. If you can breath deeply without pain (after painkillers, don’t have copd (Google it), don’t smoke, aren’t short of breath and are under 65 then no don’t go. If yes to any of the aabove go. Chest injuries can be nasty and aren’t to be messed with.

Ive had one for a few years now, I love it. Not managed to snap it either.

Plus when people are in that much pain from a stone, they don’t care where its put!

Its more effective rectally than I’m, you have a lot of blood supply to back passage, which bypasses liver metabolism and also its pretty close geographically to site of pain.

Women can get them. More common in men but do happen in women. Morphine works well, but also diclofenac up the bum can work amazingly for stone pain.

Would second that. Just because the waiting room is quiet doesn’t mean we are not busy in the resus areas. I’m an ae doc and I totally agree waiting times are a joke, 8 hours is not abnormal but behind the scenes we are often understaffed and working like stink. On a typical 12hr night shift I’m lucky to get ten minutes break. Overnight there are three ae doctors for the whole of Swansea and neath port Talbot!

Adenosine

Loads of people die in hospitals. Literally every side room/cubicle will have probably had hundreds of people die in it. Every bed in a hospital some bodies died on, in intensive care in my hospital we probably have on average a death a day. Yet nobody ever reports seeing a ghost, or a feeling or anything. Weird eh. ;-)

Mr Benjamin’s gave birth via the sunroof after 24hrs in labour! Baby Benjamin’s 9.15lbs, he’s massive. Overjoyed but a bit wrung out

Congrats! We are on the way too, prob another ten hours tho!

Contractions getting more regular now, off to the hospital in about an hour. eek.

Topical joke : whats the difference between a midwife and a terrorist? You can negotiate with a terrorist.

As will we. Mrs Benjamin’s has just broken her waters everywhere and started contracting. Feeling a tad nervous!

Currently working in a&e in swansea.

Paeds fractures are never pulled in the department, always referred to orthopaedics to be pulled under GA, provided pulses are present.

Local policies may differ – but doesnt seem to me to be ever any reason to pull a fracture without any pain relief.

Sorry I posted that before I read your original post properly!

Swansea. Better biking, better surfing, cheaper, less busy.

Op doesn’t make it clear exactly where it is on the leg, if its on or near a joint could also be a septic arthritis which is doubly bad. 2.5 hour wait or no I’d get it seen soon. Ben (dr)

That Alpacin caffeine shampoo advert really annoys me, it doesn’t actually say why on earth your hair would want to be bathed in caffeine!

still tortoise +1

They wont teach you to carve on their own, no, but its a good way to learn about weight transfer to get the ski’s on the edge. To say they don’t require proper carving technique isn’t really true, carving is really just getting the ski’s on the edge and holding them there on modern carving ski’s. Its surprising how many people cant actually do it though.

Blades, as has been said make you look a wally, but they are excellent for improving your balance on skis and also for teaching to carve well – you have to carve at speed on blades otherwise you wont be able to turn – ever heard of speed wobble!
Anyone who says they will do nothing for your technique has clearly very little skiing experience.

What i dont understand is, surely if they can just print money, they dont need to charge me any tax?

P.S. Gareths the guy in the green full face helmet

Will be sorely missed